Medical College of Wisconsin, Milwaukee, Wisconsin, United States.
Mercyhealth, Loves Park, Illinois, United States.
Appl Clin Inform. 2023 Jan;14(1):134-143. doi: 10.1055/a-2004-6669. Epub 2022 Dec 29.
Electronic medical record (EMR) systems and electronic messages are an increasingly common conduit between physicians and patients. Clear benefits of this type of communication have been established, especially among cancer patients. Studies suggest that patient portals and electronic messaging platforms can help with care coordination between oncology providers and facilitate asynchronous patient-provider communication. Despite the many benefits, there is little research regarding EMR and secure messaging use, particularly among patients with breast cancer.
The objective of this systematic review was to examine the evidence supporting the use of EMR-based messaging systems in patients with breast cancer.
A systematic literature search of Ovid MEDLINE, PubMed, Scopus, Web of Science CINAHL, and Cochrane Library was conducted. Studies were required to be published between 2005 and 2022 and report data on demographic information and electronic messaging between patients and providers. Studies were excluded if they reported insufficient data, did not include breast cancer patients, or were not published in English.
This study identified 10 articles that met inclusion criteria. The resulting studies investigated topics such as: patterns of messaging and medication adherence, cancer screening, messaging as a predictor of behavior or outcomes, and symptom management. The literature indicates that electronic messaging with providers was associated with clinical benefits for breast cancer patients and improved screening behaviors.
This review uncovered multiple areas to focus future research on, including ideal volume of electronic messages sent and their relation to prescription adherence, studies focusing solely on the breast cancer population, racial disparities in electronic messaging, and provider perceptions of electronic messaging. It is vital that more work be done to understand barriers and gaps in EMR usage to ensure that all individuals can access this increasingly essential medical service while minimizing physician workload and burnout.
电子病历 (EMR) 系统和电子消息是医生和患者之间越来越常见的沟通渠道。这种类型的沟通已经确立了明显的好处,尤其是在癌症患者中。研究表明,患者门户和电子消息平台可以帮助肿瘤学提供者进行护理协调,并促进异步患者-提供者沟通。尽管有许多好处,但关于 EMR 和安全消息传递的使用的研究很少,特别是在乳腺癌患者中。
本系统评价的目的是检查支持在乳腺癌患者中使用基于 EMR 的消息传递系统的证据。
对 Ovid MEDLINE、PubMed、Scopus、Web of Science CINAHL 和 Cochrane 图书馆进行了系统文献检索。要求研究发表于 2005 年至 2022 年之间,并报告关于患者与提供者之间的人口统计学信息和电子消息传递的数据。如果报告的数据不足、不包括乳腺癌患者或未以英文发表,则排除研究。
本研究确定了 10 篇符合纳入标准的文章。由此产生的研究调查了以下主题:消息传递模式和药物依从性、癌症筛查、消息传递作为行为或结果的预测因素,以及症状管理。文献表明,与提供者进行电子消息传递与乳腺癌患者的临床益处相关,并改善了筛查行为。
本综述揭示了多个需要关注的未来研究领域,包括发送的电子消息数量及其与处方依从性的关系、仅关注乳腺癌人群的研究、电子消息传递中的种族差异,以及提供者对电子消息传递的看法。必须做更多的工作来了解 EMR 使用中的障碍和差距,以确保所有个人都可以访问这种日益重要的医疗服务,同时最小化医生的工作量和倦怠。